Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Apr 2010
ReviewClinical update in cardiac imaging including echocardiography.
Volumetric determinations by cardiac magnetic resonance imaging after tetralogy of Fallot repair may more accurately assess significant right ventricular dilation and pulmonary regurgitation to guide timing of pulmonary valve replacement. Recent guidelines by the American and European Societies of Echocardiography have summarized the clinical approach to valvular stenosis. They emphasize aortic stenosis given its high incidence and assessment confounders such as left ventricular function, aortic regurgitation, systemic hypertension, and mitral regurgitation. ⋯ At the time of mitral surgery, moderate or greater tricuspid regurgitation should be corrected, preferably by rigid annuloplasty. Recent evidence also supports tricuspid annuloplasty for an annular diameter >35 mm regardless of regurgitation severity. Although repair is preferred, tricuspid replacement also has acceptable outcomes.
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J. Cardiothorac. Vasc. Anesth. · Apr 2010
Comparative StudySpeckle tracking for the intraoperative assessment of right ventricular function: a feasibility study.
Speckle tracking is an ultrasound method that assesses B-mode features to measure tissue displacement and derive deformation parameters. The objective of this study was to assess the feasibility of using speckle tracking in the measurement of right ventricular (RV) longitudinal strain during cardiac surgery using transesophageal echocardiography (TEE). ⋯ Perioperative measurements of RV strain using TEE in ventilated patients is feasible. The success rate was higher using TEE in ventilated patients under anesthesia. Differences between the 2 methods were likely the result of differences in 2-dimensional image quality.
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J. Cardiothorac. Vasc. Anesth. · Apr 2010
Comparative StudyInadequate visualization and reporting of ventricular function from transthoracic echocardiography after cardiac surgery.
The purpose of this study was to determine the incidence of and risk factors for inadequate reporting of ventricular function from transthoracic echocardiography after cardiac surgery. ⋯ Transthoracic imaging is often inadequate in patients who have undergone recent cardiac surgery. Patient and surgical characteristics influence reporting of right and left ventricular function.
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J. Cardiothorac. Vasc. Anesth. · Apr 2010
Comparative StudyCardiac index validation using the pressure recording analytic method in unstable patients.
The authors investigated the accuracy and precision of the pressure recording analytic method (PRAM) in cardiac index measurement compared with thermodilution in unstable patients, a setting in which minimally invasive monitoring devices often fail. ⋯ This study showed that PRAM, a minimally invasive method for cardiac index assessment, is clinically useful even in unstable patients such as those receiving intra-aortic balloon pump and/or ongoing high doses of a inotropic drugs because of a low cardiac output syndrome but without atrial fibrillation.
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J. Cardiothorac. Vasc. Anesth. · Apr 2010
Comparative StudyLongitudinal assessment of neurocognitive function in rats after cardiopulmonary bypass: evidence for long-term deficits.
Neurologic and neurocognitive dysfunction after cardiopulmonary bypass (CPB) have been shown in both clinical and experimental settings. Although short-term outcome has been evaluated in rats, the assessment of neurocognitive dysfunction with long-term follow-up has not been reported in experimental CPB models. The objective of this study was to evaluate the effects of CPB on long-term neurocognitive function in the rat. ⋯ Compared with sham-operated controls, rats undergoing CPB showed worse neurologic and neurocognitive outcome early after surgery. Importantly, long-term deficits also persisted at 6 weeks after surgery.